角膜交联术治疗进展期圆锥角膜并发症的观察

发布时间：2018-05-22 18:33

本文选题：角膜交联术 + 进展期圆锥角膜　；参考：《眼科》2017年05期

【摘要】：目的总结角膜交联术治疗进展期圆锥角膜的并发症。设计回顾性病例系列。研究对象2015年1-12月北京同仁医院收治的进展期圆锥角膜患者40例(40眼)。方法回顾性分析患者术后临床资料,术前含上皮最薄角膜厚度在375~450μm,行去上皮角膜交联术。术后1天、3天、1周、1个月通过问卷调查对患者疼痛感及异物感程度进行评估,并行眼前节检查。主要指标患者治疗前后视力、眼压、眼部疼痛程度、角膜上皮修复及角膜水肿情况。结果患者术后1天存在明显疼痛感(3.19±0.37分)与异物感(3.15±0.23分),可见部分角膜上皮缺损,术后3天患者异物感(2.23±0.43分)与疼痛(2.23±0.32分)感明显减轻,且角膜上皮大部分修复;术后1周,所有患者仅有轻微异物感(0.23±0.07分)及疼痛(0.22±0.11分),角膜上皮基本修复。术后1个月患者无明显异物感及疼痛感。随访6个月,40例患者病情均得到控制,30例患者术后复查裸眼视力均有不同程度提高,35例患者矫正视力有明显提高,无角膜感染、瘢痕、溃疡、上皮缺损等并发症发生。结论角膜胶原交联术治疗进展期圆锥角膜效果好,主要并发症是术后早期疼痛及角膜上皮缺损。
[Abstract]:Objective to summarize the complications of corneal crosslinking in the treatment of advanced keratoconus. Design retrospective case series. Participants 40 patients with advanced keratoconus admitted to Tongren Hospital in Beijing from January to December 2015 were treated with 40 eyes of keratoconus. Methods retrospective analysis of postoperative clinical data showed that the thinnest corneal thickness was 375 渭 m. The degree of pain and foreign body sensation was evaluated by questionnaire, and the anterior segment was examined. Main outcome measures visual acuity, intraocular pressure, degree of ocular pain, corneal epithelial repair and corneal edema before and after treatment. Results there were significant pain (3.19 卤0.37) and foreign body (3.15 卤0.23) and partial corneal epithelial defects (2.23 卤0.43) and 2.23 卤0.32 (2.23 卤0.32) and most of corneal epithelium were repaired 1 week after operation. All the patients had only slight foreign body sensation (0.23 卤0.07) and pain (0.22 卤0.11), and the corneal epithelium was basically repaired. One month after operation, there was no obvious foreign body sensation or pain in the patients. All 40 patients were controlled for 6 months. After operation, the uncorrected visual acuity was improved significantly in 35 patients. There were no complications such as corneal infection, scar, ulcer, epithelial defect and so on. Conclusion Corneal collagen crosslinking is effective in the treatment of advanced keratoconus. The main complications are early postoperative pain and corneal epithelial defect.
【作者单位】：首都医科大学附属北京同仁医院北京同仁眼科中心眼科学与视觉科学北京市重点实验室;
【分类号】：R779.6

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